Outcomes in TBI With Violent Versus Nonviolent Etiology in a Predominantly Rural Setting

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Abstract

Objective

To evaluate differences in outcome in persons with violent versus nonviolent traumatic brain injury (TBI) etiology.

Design

Two-group (violent vs nonviolent) 1-year follow-up study.

Setting

Midwestern medical center TBI Model System serving a predominantly rural catchment area.

Participants

Forty-five (n = 19 violent TBI etiology; n = 26 nonviolent TBI etiology) inpatients with primary diagnosis of TBI followed up as outpatients 1 year after injury.

Main outcome measures

Substance use, income source, employment status, Wechsler Adult Intelligence Scale—Revised (abbreviated version), Logical Memory I and II from the Wechsler Memory Scale—Revised, Wide Range Achievement Test—Third Edition Reading subtest, Trail-Making Tests A and B, Rey Auditory Verbal Learning Test, Community Integration Questionnaire, Neurobehavioral Functioning Inventory.

Results

Members of the violent group were more likely to be men, of a racial minority, unemployed, and have low income. Substance abuse was common among both groups prior to injury, with significant declines at 1 year. Follow-up also revealed significant group differences in verbal intelligence, social integration, productivity, and source of income, but nonsignificant difference in employment. In all comparisons, more favorable outcomes were found for the nonviolent group.

Conclusions

Persons with violent injury etiology have poorer premorbid functioning and are likely to have less favorable outcomes than the general population with TBI. Therefore, persons with violent TBI etiology may require more intensive aftercare programming to promote improved rehabilitation outcomes.

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